2. Bacillus

3.  ~ 60 species; Gram-positive or Gram-variable bacilli Large (0.5 x 1.2 to 2.5 x 10 um) Most are saprophytic contaminants or normal flora Bacillus anthracis is most important member  Produce endospores  Aerobic or facultatively anaerobic  Catalase positive (most) Rapidly differentiates from Clostridium  Bacillus spp. are ubiquitous Soil, water, and airborne dust Thermophilic ( 5-8°C) Can flourish at extremes of acidity & alkalinity (pH 2 to 10) General Characteristics of Bacillus

4. Diseases Associated with Bacillus

5.  On blood agar Large, spreading, gray-white colonies, with irregular margins Many are beta-hemolytic (helpful in differentiating various Bacillus species from B. anthracis)  Spores seen after several days of incubation, but not typically in fresh clinical specimens Laboratory Characteristics of Bacillus

7. Bacillus anthracis

8. Summary of B. anthracis Infections

9. Summary of B. anthracis Infections (cont.)

10. Epidemiology of Bacillus anthracis  Rare in the US (1974-1990, 17 cases reported by CDC)  Enzootic in certain foreign countries (e.g., Turkey, Iran, Pakistan,and Sudan)  Anthrax spores infectious for decades Biologic warfare experiments (annual tests for 20 years) Gruinard, off western coast of Scotland 4 x 10e14 fully virulent spores exploded Eliminated in 1987 (formaldehyde & seawater)  Three well-defined cycles Survival of spores in the soil Animal infection Infection in humans

11. Epidemiology of Bacillus anthracis (cont.)  Primarily a disease of herbivorous animals  Most commonly transmitted to humans by direct contact with animal products (e.g., wool and hair)  Also acquired via inhalation & ingestion Increased mortality with these portals of entry  Still poses a threat Importing materials contaminated with spores from these countries (e.g., bones, hides, and other materials) Usually encountered as an occupational disease Veterinarians, agricultural workers

12. Epidemiology of Anthrax in Animal and Human Hosts

13. Clinical Presentation of Anthrax Cutaneous Anthrax  95% human cases are cutaneous infections  1 to 5 days after contact  Small, pruritic, non-painful papule at inoculation site  Papule develops into hemorrhagic vesicle & ruptures  Slow-healing painless ulcer covered with black eschar surrounded by edema  Infection may spread to lymphatics w/ local adenopathy  Septicemia may develop  20% mortality in untreated cutaneous anthrax

14. Clinical Presentation of Anthrax Inhalation Anthrax  Virtually 100% fatal (pneumonic)  Meningitis may complicate cutaneous and inhalation forms of disease  Pharyngeal anthrax Fever Pharyngitis Nneck swelling

15. Clinical Presentation of Anthrax Gastrointestinal (Ingestion) Anthrax  Virtually 100% fatal  Abdominal pain  Hemorrhagic ascites  Paracentesis fluid may reveal gram-positive rods

16. Treatment & Prophylaxis  Treatment Penicillin is drug of choice Erythromycin, chloramphenicol acceptable alternatives Doxycycline now commonly recognized as prophylactic  Vaccine (controversial)  Laboratory workers  Employees of mills handling goat hair  Active duty military members  Potentially entire populace of U.S. for herd immunity

17. Characteristic Bacillus anthracis Other Bacillus spp. Hemolysis Neg Pos Motility Neg Pos (usually) Gelatin hydrolysis Neg Pos Salicin fermentationNeg Pos Growth on PEA blood agar Neg Pos Key Characteristics to Distinguish between B. anthracis & Other Species of Bacillus

19. Bacillus cereus

20. Summary of B. cereus Infections

21. Summary of B. cereus Infections (cont.)

22. Gram-Variable Stain of B. cereus with Endospores

23. Foodborne Diseases of B. cereus (Intoxication)(Foodborne Infection)

24.  Bacillus thurigensis BT corn; Other GMO’s (genetically modified organisms)  Bacillus stearothermophilus Spores used to test efficiency of killing in autoclaves Other Bacillus spp.

26. REVIEW Bacillus

27.  ~ 60 species; Gram-positive or Gram-variable bacilli Large (0.5 x 1.2 to 2.5 x 10 um) Most are saprophytic contaminants or normal flora Bacillus anthracis is most important member  Produce endospores  Aerobic or facultatively anaerobic  Catalase positive (most) Rapidly differentiates from Clostridium  Bacillus spp. are ubiquitous Soil, water, and airborne dust Thermophilic ( 5-8°C) Can flourish at extremes of acidity & alkalinity (pH 2 to 10) General Characteristics of Bacillus REVIEW

28. Diseases Associated with Bacillus REVIEW

29. Review of Bacillus anthracis REVIEW

30. Bacillus anthracis REVIEW

31. Summary of B. anthracis Infections REVIEW

32. Summary of B. anthracis Infections (cont.) REVIEW

33. Epidemiology of Anthrax in Animal and Human Hosts REVIEW

34. Clinical Presentation of Anthrax Cutaneous Anthrax  95% human cases are cutaneous infections  1 to 5 days after contact  Small, pruritic, non-painful papule at inoculation site  Papule develops into hemorrhagic vesicle & ruptures  Slow-healing painless ulcer covered with black eschar surrounded by edema  Infection may spread to lymphatics w/ local adenopathy  Septicemia may develop  20% mortality in untreated cutaneous anthrax REVIEW

35. Clinical Presentation of Anthrax Inhalation Anthrax  Virtually 100% fatal (pneumonic)  Meningitis may complicate cutaneous and inhalation forms of disease  Pharyngeal anthrax Fever Pharyngitis Nneck swelling REVIEW

36. Clinical Presentation of Anthrax Gastrointestinal (Ingestion) Anthrax  Virtually 100% fatal  Abdominal pain  Hemorrhagic ascites  Paracentesis fluid may reveal gram-positive rods REVIEW

37. Treatment & Prophylaxis  Treatment Penicillin is drug of choice Erythromycin, chloramphenicol acceptable alternatives Doxycycline now commonly recognized as prophylactic  Vaccine (controversial)  Laboratory workers  Employees of mills handling goat hair  Active duty military members  Potentially entire populace of U.S. for herd immunity REVIEW

38. Review of Bacillus cereus REVIEW

39. Summary of B. cereus Infections REVIEW

40. Summary of B. cereus Infections (cont.) REVIEW

41. Foodborne Diseases of B. cereus (Intoxication)(Foodborne Infection) REVIEW